Incapacity/Estate Planning & Asset Preservation

Phone: (954) 975-5159
Fax: (954) 972-4701

c/o MacLean & Ema
2600 N.E. 14th Street Causeway
Pompano Beach, Florida 33062

SEE ALSO:
Florida's Voice on Developmental Disabilities
www.floridasvoice.org

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medicaid Fact Sheet (2011): for Beginners Only

Criteria for Qualification

A. Medical

  • Evaluation by CARES Unit upon application
    • NOTE: If medical qualification may be questionable, you may call to arrange a free private assessment prior to applying; Call 954/597-2240 in Broward County
  • Applicant must need assistance &/or skilled nursing care 24 hr. day, 7 days a week
    • NOTE: mere dementia is not enough; custodial care needs is not “skilled” care

B. Income

  • Applicant's income cannot exceed $ 2,250.00 gross income per month.
  • NOTE: If income exceeds this figure, an irrevocable qualified income trust (QIT) [a/k/a "Miller Trust") must be executed (& the bank account funded) in month of application (& excess income must be deposited into QIT bank account in each month thereafter). If married, spouse's income n/a for qualification purposes: Spouse's income is only considered after applicant qualifies & for purposes of diversion of some of applicant- spouse's income to the community spouse at home [NOTE: Community Spouse Income Allowance/CSIA is not applicable to the at-home Medicaid waivers nor when Spousal Refusal is used by community spouse]. Court order could increase CSIA.

C. Assets

  • Applicant's assets cannot exceed $ 2,000 countable assets + all "exempt" assets
  • If married couple both file for Medicaid, asset cap for both is $ 3,000 + exempt assets
  • If married, and 1 spouse files for Medicaid, the community (non-applicant) spouse's assets cannot exceed $ 123,600.00 + "exempt" assets.
  • BEWARE: Have any assets been gifted (transferred without fair market return) to anyone other than a spouse in past 5 years? Only intra-spousal transfers/gifts are generally
    O.K. [unless post-application & spousal refusal utilized].
  • PENALTIES FOR "GIFTING" - If during the 5 year lookback at application time, transfers/gifts/donations must be disclosed & could trigger disqualification. Transfers post 11/1/07 fall under federal/Fla.Deficit Reduction Act of 2005 rules. Time Penalty: Divide transfed amt. by transfer penalty divisor [$ 8,944 as of 6/1/17]

  ICP/Nursing Home ALF Waivers Home Waivers
Income: Applicant: $ 2,199/mo. gross Applicant: Applicant:
Cap (3 x $ 750/SSI = $ 2,250.00)

Same as ICP

Same as ICP

  [Community Spouse at home:Income n/a except to determine CSIA]
Assets: Applicant: $ 2,000 + exempt

Applicant:

Applicant:

Cap [If couple: $ 3,000 + exempt] Same as ICP Same as ICP
  [Community Spouse at home: $ 123,600.00 asset cap + exempt (all programs)] Home Equity Limit: $ 572,000.00; [ Personal Needs Allowance is $ 105.00]

WAIVER WAIT LISTS: ADRC 954/745-9779; Miami 305/670-4357; Palm Beach Cty. 866/684-5885

30% Augmented Elective Estate: If married & receiving Medicaid & if community spouse at home ("the wrong spouse") predeceases the spouse on Medicaid, Medicaid funding could be lost.



Low income subsidy program to help with Medicare Part B & Part D Premiums: Go to www.ssa.gov for financial assistance. Part B Medicare premium = $134.00 or more. Go to http://www.myflorida.com/accessflorida for QMB/SLMB help with Medicare Part B deductibles/coinsurance/premiums (QMB) - or - help with Medicare Part B premium only (SLMB).

Non-service connected VA PENSION W/ AID & ATTENDANCE: Unlike Medicaid, no transfer penalties but net worth test (Will you outlive your assets?) & unreimbursed medicals must > income. For veteran/vet's widow/er. Requires 90 day active duty (inc. 1 day wartime) etc. Go to www.va.gov


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